發(fā)布時(shí)間：2018-11-26 10:32

【摘要】：擴(kuò)張型心肌病(dilated cardiomyopathy,DCM)患者心腔內(nèi)血栓發(fā)生率及臨床血栓栓塞事件發(fā)生率均較高。心腔內(nèi)血栓形成與多種因素有關(guān),如心臟擴(kuò)大、心內(nèi)膜面改變、心肌運(yùn)動(dòng)減弱、血流淤滯、心律失常、血液高凝狀態(tài)等。目前針對(duì)擴(kuò)張型心肌病患者加用抗凝劑治療的專家建議是:左心室射血分?jǐn)?shù)(left ventricular ejection fraction,LVEF)30%,有栓塞表現(xiàn)的病史,或超聲心動(dòng)圖發(fā)現(xiàn)附壁血栓形成。心臟擴(kuò)大患者有報(bào)道把阿司匹林或阿司匹林聯(lián)合水蛭素類藥等納入常規(guī)治療方案,合并房顫(atrial fibrillation,AF)則加用華法林或新型口服抗凝藥(novel oral anticoagulants,NOACs)治療,本文僅對(duì)擴(kuò)張型心肌病患者栓塞風(fēng)險(xiǎn)流行病學(xué)、發(fā)生機(jī)制和防治進(jìn)行綜述。
[Abstract]:The incidence of intracardiac thrombus and clinical thromboembolism were higher in patients with dilated cardiomyopathy (dilated cardiomyopathy,DCM). The formation of intracardiac thrombus is related to many factors, such as heart enlargement, endocardial changes, decreased myocardial movement, blood flow stagnation, arrhythmia, hypercoagulability and so on. At present, the expert advice for patients with dilated cardiomyopathy treated with anticoagulant is: left ventricular ejection fraction (left ventricular ejection fraction,LVEF) 30, have a history of embolism, or echocardiography found mural thrombosis. Patients with cardiac enlargement have been reported to have included aspirin or aspirin combined with hirudin as part of a routine regimen, while atrial fibrillation (atrial fibrillation,AF) was treated with warfarin or a new oral anticoagulant, (novel oral anticoagulants,NOACs. This article reviews the risk epidemiology, pathogenesis, prevention and treatment of embolism in patients with dilated cardiomyopathy.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院心血管內(nèi)科;
【基金】：重慶市衛(wèi)生局科研資助項(xiàng)目(編號(hào):2013-1-010)
【分類號(hào)】：R542.2

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本文編號(hào)：2358321